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An antidepressant medication is prescribed for a client who reports sleeping only 4 hours in the past 2 days and weight loss of 9 lbs within the last month. Which client goal is most important to achieve within the first three days of treatment?
- A. Meet scheduled appointment with a dietitian.
- B. Sleep at least 6 hours a night.
- C. Understand the purpose of the medication regimen.
- D. Describe the reasons for hospitalization.
Correct Answer: B
Rationale: The most important goal to achieve within the first three days of treatment is to ensure the client can sleep at least 6 hours a night. Adequate sleep is essential for stabilizing mood and improving overall functioning. Choice A is not as urgent as improving sleep patterns. Choice C is important but not as immediate as addressing the sleep deficit. Choice D is unrelated to the immediate treatment goal of improving sleep and managing symptoms of depression.
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When preparing to administer a domestic violence screening tool to a female client, which statement should the RN provide?
- A. If your partner is abusing you, I need to ask these questions.
- B. State law mandates that I ask if you are a victim of domestic violence.
- C. The healthcare provider needs to know if you are experiencing any domestic abuse.
- D. All clients are screened for domestic abuse because it is common in our society.
Correct Answer: D
Rationale: The correct answer is D because screening all clients for domestic abuse helps normalize the process and reduces the stigma, encouraging honest responses. Choice A is not the best option as it may come off as accusatory and can deter the client from being open. Choice B, mentioning state law, may create fear or pressure, affecting the client's response. Choice C focuses on the healthcare provider's needs rather than emphasizing the client's well-being, which may not facilitate open communication.
The nurse is assessing a client who has schizophrenia and is exhibiting symptoms of paranoia. Which behavior would the nurse most likely observe?
- A. The client is seen as unmotivated and withdrawn.
- B. The client is preoccupied with a fear of being harmed.
- C. The client displays a blunted affect and lacks emotional response.
- D. The client avoids group activities and shows decreased appetite.
Correct Answer: B
Rationale: In clients with paranoia, they typically exhibit an intense fear of being harmed, persecuted, or targeted by others. This fear often dominates their thoughts and can significantly impact their daily functioning and interactions. Choice A, being unmotivated and withdrawn, is more indicative of negative symptoms of schizophrenia, such as avolition and social withdrawal. Choice C, displaying a blunted affect and lacking emotional response, is associated with flat affect, a symptom commonly seen in schizophrenia but not specific to paranoia. Choice D, avoiding group activities and showing decreased appetite, may be related to various symptoms or side effects, but it is not a defining characteristic of paranoia in schizophrenia.
A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting, and drowsiness. What action should the nurse take?
- A. Notify the healthcare provider immediately and prepare for administration of an antidote.
- B. Hold the medication and refrain from administering additional amounts of the drug.
- C. Record the symptoms as normal side effects and continue administration of the prescribed dosage.
- D. Notify the healthcare provider of the symptoms before the next administration of the drug.
Correct Answer: A
Rationale: Diarrhea, vomiting, and drowsiness in a client being treated with lithium carbonate for bipolar disorder may indicate lithium toxicity. The nurse should promptly notify the healthcare provider to ensure immediate medical intervention. The correct action is to prepare for the administration of an antidote if necessary. Holding the medication (Choice B) could delay necessary treatment. Considering the symptoms as normal side effects (Choice C) is incorrect as they suggest a potential serious issue. Notifying the healthcare provider before the next administration of the drug (Choice D) may delay urgent intervention required for lithium toxicity.
An adolescent with a history of bipolar disorder is hospitalized during a manic episode. Which intervention is most appropriate for the nurse to include in the care plan?
- A. Encourage high levels of physical activity.
- B. Provide a quiet and structured environment.
- C. Engage the client in creative arts activities.
- D. Allow the client to make decisions about their schedule.
Correct Answer: B
Rationale: During a manic episode, individuals with bipolar disorder may experience heightened energy levels, decreased need for sleep, and racing thoughts. Providing a quiet and structured environment is crucial in managing these symptoms as it helps reduce external stimuli, prevent overstimulation, and promote a sense of calmness. Encouraging high levels of physical activity may exacerbate the manic symptoms by further increasing stimulation and excitement. Engaging the client in creative arts activities might be beneficial during stable periods but may not be the most appropriate intervention during a manic episode. Allowing the client to make decisions about their schedule could potentially lead to impulsivity and poor judgment, which are common characteristics of mania.
A client who is known to abuse drugs is admitted to the psychiatric unit. Which medication should the nurse anticipate administering to a client who is exhibiting benzodiazepine withdrawal symptoms?
- A. Diphenhydramine (Benadryl)
- B. Perphenazine (Trilafon)
- C. Isocarboxazid (Marplan)
- D. Chlordiazepoxide (Librium)
Correct Answer: D
Rationale: Chlordiazepoxide (Librium) is the correct choice for managing benzodiazepine withdrawal symptoms. Benzodiazepines are commonly used drugs that can lead to physical dependence, and abrupt discontinuation can result in withdrawal symptoms. Chlordiazepoxide, a benzodiazepine itself, is often used in a controlled manner to taper off the drug gradually and manage withdrawal symptoms effectively. Choice A, Diphenhydramine, is an antihistamine and not typically used to manage benzodiazepine withdrawal. Choice B, Perphenazine, is an antipsychotic medication used to treat psychotic disorders, not specifically benzodiazepine withdrawal symptoms. Choice C, Isocarboxazid, is a monoamine oxidase inhibitor (MAOI) used in the treatment of depression and not indicated for benzodiazepine withdrawal.